Individual provider Active NPI

Olubukola Sowunmi, PHARMD

  • Pharmacist
  • Atwater, CA
National Provider Identifier
1578098141
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73423 Issued in CA
Practice address
1651 Bellevue Rd
Atwater, CA 95301-2608
Phone
(209) 358-3304
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73423 CA Primary

Addresses

Primary practice location

1651 Bellevue Rd
Atwater, CA 95301-2608

Mailing address

1651 Bellevue Rd
Atwater, CA 95301-2608
Phone (209) 358-3304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
73423CAMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. Past Accepting new patients
Garfield Beach CVS, L.L.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1578098141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 BELLEVUE RD",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953012608",
            "telephone_number": "209-358-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 BELLEVUE RD",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953012608",
            "telephone_number": "209-358-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOWUNMI",
        "first_name": "OLUBUKOLA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "73423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atwater, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.